Bigeminy vs Trigeminy


For a healthy heart to function, it should beat in a steady rhythm with the lower and upper chambers beating in a consistent pattern. After each heartbeat, there should be a slight pause and then the heartbeat resumes. 

Irregular heartbeats and unusual heart rhythms are often labeled as either bigeminy or trigeminy, depending on the sequence of beats and irregularities within the heart. For example, with patients that suffer from bigeminy, each regular heartbeat is followed by another heartbeat that arrives prematurely, in a series of long and short beats. For sufferers of trigeminy, the heart tends to beat in an unusual three-beat pattern.

Don’t worry if you’re a little confused between bigeminy and trigeminy, we’re going to break down both of them for you. 

What is Bigeminy  

As mentioned before, if you suffer from bigeminy, each of your regular heartbeats is followed by a heartbeat that arrives too quickly. Each pair of beats are considered as “twins,” which is where the name bi – Gemini comes from. 

In the medical world, if those early heartbeats come from the heart’s ventricles, they’re known as premature ventricular contractions or PVCs. If the early heartbeats emerge from the heart’s upper chambers, also known as the atria, then they’re referred to as premature atrial contractions (PACs.)

Whenever your heart beats, the right ventricle pumps blood to the lungs in order to exchange carbon dioxide for oxygen. The left ventricle pumps blood through the aorta to the entire body and while this is happening, the atria fill with blood and move it downwards into the ventricles, in preparation for the next heartbeat. 

Blood will move into the ventricles between each heartbeat, however, you will feel a skipped beat if your heart has a premature contraction before the ventricles are able to fill with blood. The premature contraction will most likely feel different from a regular heartbeat because little or no blood at all is being pumped out of the heart. If your heart’s ventricles have had more time to fill with blood, your premature heartbeats will be more noticeable and the resulting sensation will make the heart feel like it’s faster than usual. 

when to worry about bigeminy

Causes of Bigeminy 

There can be many causes of bigeminy, such as:

  • Heart disease
  • High blood pressure
  • Caffeine
  • Excessive alcohol consumption 
  • Tobacco 
  • Anxiety
  • Exercise
  • Chemical imbalances 

If you do experience any of the symptoms of bigeminy, such as your heart beating faster than usual or your heart skipping a beat, then its crucial to contact a physician as soon as possible.  

What is Trigeminy

The three-beat pattern that doctors call trigeminy is a pattern of either two normal beats and an irregular one or two irregular beats with a regular beat. 

The heart has the ability to conduct its own electricity, that travels on a regular route. The electrical signals follow certain pathways and areas of the heart that communicate signals for the nearby heart muscle to beat. In the majority of people, electrical signals follow a designated pathway that can be traced with a portable EKG monitor

In some patients, the electrical signals can follow a different path that results in abnormal heart rhythms. The cause of trigeminy is an irritable area of the heart, where another area of the heart emits a separate signal that has an effect on how the heart beats. This is a normal occurrence for some people, there’s nothing wrong with their health or heart, it just has a different rhythm in comparison to most of the world. 

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Causes of Trigeminy

It’s important to seek medical advice if you suffer from any of the symptoms of trigeminy. The symptoms are an elevated heart rate with a fluttering in the chest, chest pains, shortness of breath and syncope. 

Trigeminy can also be temporarily triggered by certain substances, such as: 

  • Cocaine
  • Alcohol
  • Caffeine
  • Methamphetamines
  • Nicotine
Causes of Trigeminy

The Bottom Line

It can be difficult to spot the symptoms of bigeminy and trigeminy, so if you do notice any tightness in the chest area with unusual heartbeats, it’s important to get yourself booked in with your physician for an EKG, as soon as possible. 

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Where should I buy Portable EKG Monitor online?

Portable EKG monitors need to come from safe, reputable, and trusted medical technology providers. While there are many websites offering EKG monitors online, most of these are resellers. In many cases, it’s impossible to determine whether you’re getting the real thing. If you’re buying online, stick to the website of each provider. It’s the only way to ensure you’re getting the real thing. Here at, you’ll find the EKGraph, an exclusive smart, wireless, and portable EKG monitor.

Is Trigeminy worse than Bigeminy?

Generally speaking, no, it isn’t. For a vast number of people, trigeminy is a relatively normal occurrence. Most people who experience trigeminy have no other symptoms and lead perfectly normal lives. On the other hand, bigeminy does pose somewhat serious health risks over time. Many people experience bigeminy at some point in their life without consequence, particularly children and teens. However, bigeminy does put you at an increased risk of developing arrhythmias, which can produce fatal blood clots and strokes. Additionally, the extra strain on the heart produces enlargement of the organ and possible heart failure.

What should i do after having the symptoms of bigeminy and trigeminy

Bigeminy and trigeminy are rather subtle conditions, most of the time. Their symptoms are hard to identify, especially for patients experiencing them. When you start to notice feeling a tightness in your general chest area, especially combined with unusual heartbeat patterns, you need a professional opinion. You will have to make an appointment with your doctor to get an EKG. An EKG can confirm whether or not your symptoms actually match either of the conditions. Then, you can be properly diagnosed and treated.

18 thoughts on “Bigeminy vs Trigeminy

  1. Pamela Thirlaway says:

    Thank you for this information. I have been diagnosed with ventricular ectopy with bigeminy and trigeminy. The consultant did not explain what this was so finding your information was good. Thank you.

    • says:

      Thank you for the encouraging words Pamela! We specialize in heart health and actually sell a portable EKG device that you can use at home. Can help you capture heart issues that you Doctor missed.

  2. Mary Charlotte Hall says:

    My EKG results, following 24 hour Holter monitor, are written as follow: “PVCs, V Couplets, V- Bi Trigeminy”.
    1.What does the “V” indicate, and is the condition being reported “Bi-“ or “Tri-“ geminy???
    2. How do these three conditioners work ( or not work) together?

    • Polly Hasty says:

      The V stands for ventricular. And I believe the Bi- Trigeminy would indicate its both. As for your other question, you need to take that to your cardiologist and have them explain it to you. Its been a few years since i worked on a cardiac floor, so I wouldn’t want to speak out of turn. Plus these are diagnostic tools, and those with the ability to diagnose in their scope of practice should be the ones answering that question.

  3. Hayley says:

    Hi there,
    Does anyone experience similar symptoms to mine. I have had triple bypass surger, after which I suffered a few episodes of atrial fibrillation. However, when they eased up, I continued to experience the PVC’s – two or three beats; then a missed one, that I’d often had before my bypass.

    As time has gone on, these have become more troublesome. Instead of a day or two of ‘blip, blip, blipping, I began to get it 24/7. Last Tuesday, it started. The doctor told me that it would probably be okay in a couple of days; it wasn’t; it just went on and on, until I thought that either my heart would burst or my mind would snap. I was freaking out and couldn’t bear the irregularity.

    By Saturday, it had become so terrifying, that I went to A & E. I was given two ecg tests, X-Ray and blood tests. Among other, unrelated health issues, they diagnosed ‘Trigeminy’. They gave me an extra dose of Bisoprolol and told me to take it every day, making 15mg altogether. It made me tired; I barely knew what I was doing owing to the extreme tiredness, and I didn’t know where I was going, when, in fact, I had already been there. However, I persevered because i would try ANYTHING to get rid of this life destroying and terrifying problem – but my heart still continues to beat to the rhythm of the William Tell Overture, and I don’t know how much more I can take.

    Last night I really thought that I was going to die, and my husband wanted me to call for an ambulance; but I had already been to the hospital on Saturday, and I knew that I wouldn’t come away feeling better.

    I am currently waiting for an appointment with a cardiologist, and an echo scan and, possibly, a twenty-four hour monitor.

    When I get these irregular beats – and I still have them now – I experience a strange and unpleasant feeling of discomfort at the base of my throat. I couldn’t really describe it as ‘tightness’ but it is a horrid feeling all the same. Sometimes, there is discomfort in my stomach, too, like a contraction of the muscles.

    It is all so terrifying, and when they just won’t go away, it can be so tiring, as well as extremely frightening. My heart has been beating this way since last Tuesday, and no matter how hard I have tried to put across how scared I am, and unwell I feel, there really are no words to adequately describe it.

    At times like this, I feel as if I am about to die. I can’t understand how someone can feel this way, with their heart seemingly ‘caving in’, and not die.

    I would be interested to hear about how others cope with irregular heartbeats, since I am not coping at all. I just become very morbid, extremely despondent, and, when my heart is ‘short circuiting’, I feel as if I am on another planet to those whose lives are not complicated by this awful problem. I also feel angry about it at times.

    My very best wishes to anyone out there who has to endure the miser of of heart irregularity. I hope that you will get them under control very soon.

    • Helen Webster says:

      Hi Hayley,
      I feel for you. At one point my PVC’s were 10 a minute. They were driving me crazy. I also get an occasional fast heart rate and I also showed Ventricular Trigeminy present on my ZIO monitor. I do keep a good diet because I have diabetes, which I control with no medications. Although cardiologists see no correlation with this I decided to eliminate Gluten from my diet. I googled this and it said there is. My PVC’s have improved greatly! This is just a thought.
      Good luck to you Hayley!

    • Dianne says:

      Heart disease is in my family. My MOM had triple bypass after her heart attack. She stayed in a-fib for the rest of her life. The arrhythmia didn’t bother her. But my Aunt had it and was more symptomatic or aware of the arrhythmia. Every is different in feelings and symptoms. My MOM was good at clearing awareness out of her mind and trusting G~D would take her home when her time in life was finished. She accepted Christ and was more comfortable with life and belief in Christ helped ease her fear of the unknown. Christ is always with you to comfort you no matter the circumstances.

    • Nick says:

      I go through this regularly. I do have cardiomyopathy which is the cause of the problem. It’s an awful feeling,I am told that many people have this but don’t notice the arrhythmias, they are lucky I feel everyone and it is very depressing. I was changed from Bisoprolol to Sotalol and this has helped and I don’t get the arrhythmias as much

  4. Jennifer says:

    I just went to the doctor this week and the ECG results said ventricular trigeminy I had stents 5 in 2018 I just lost my big brother 5 months ago to unexpected esophagus cancer my lil brother has lung cancer I’ve been under a lot of stress this is hard for me im only 52 but im wondering since the lower chamber of my heart has a third beat is there any medication that can help without having the ablation

  5. Keith S. says:

    I love my Sonohealth monitor. I’ve had heart disease for a while, but never could get tracings of when I was feeling a problem. I’ve had Covid three times this year (lucky me, and I’m fully vaxed). The first Covid case caused R on T a few times along with my BP spiking high enough to require two BP meds. The third time I had Covid, the opposite occurred and my BP stays very low and BP meds were removed. Unfortunately, I have developed Regurgitation in 3 heart valves and most every night have either Bigeminy or Trigeminy while laying flat. My heart monitor from Sonohealth has caught it all and has helped me show my physicians what I’m experiencing. You can’t beat (no pun intended) the piece of mind having this hand held monitor provides when I feel an episode coming on and can see why I’m feeling badly.

  6. Rebecca Hoskins says:

    I have exactly the same thing . Bigeminy and then sometimes trigeniny. Makes day to day living really hard work . . I ama a teacher in a large high school and it leaves me feeling very light headed / drained

  7. Dave london says:

    I’ve had ectopics bi and trigenimi for 4 yrs constantly my pulse at 20 to 40bpm feel drained and light headed and passed out hospital are says not heart attack and sends me home, a nightmare can’t live my life

  8. Rosie Guerra says:

    In a current episode and I am looking for help. Some kind of answers. I’ve been to the ER and CV they say it’s fine. But I can’t sleep. I can barely get up some days. I feel like im dying at moments. Last time I was in the ER I was have 28 PVCs a min. And they sent me home. Im so exhausted.

    • Brennen Mccomas says:

      Hi Hayley. I too get these for the last 10 years. Roughly 10-15000 daily. I am with you on how much they can bother you. One thing you should try is Xanax. If they go away with Xanax it might show that it’s the stress that is contributing. I have been told I have a completely healthy heart. While we are different in that aspect I have had them consistently for over 10 years with no change structurally from the tests. Stress can do some funny things but it’s not always dangerous.

  9. Nicholas Morello says:

    I have the same expierences. 5,000 to 7000 pvcs a day, many bigeminy and trigeminy too, i bought an ecg for home was about 230 dollars, i can see, i think i get them when i have bad episodes of gerd and gas, i feel them all scary, I’m tired of it, but I’ve been to the ER and had 30 a min on the monitor they didn’t seem concerned, if 10 percent of heart beats are PVC over time it can weaken heart, but every doctor i talk to doesn’t seem like its a big deal

    • Brennen Mccomas says:

      Same here! I get about 10,000+. Cardiologist is not concerned. It drives me nuts. One thing that’s helped besides diet and exercise is propranolol and low dose of Clonazepam. If you want to go down a rabbit hole try some desiccated animal organs and a fruit and meat diet. I feel freaking fantastic except for the billion pvc and pacs daily.

  10. Louise says:

    I was diagnosed with Dilated Cardiomyopathy last year. EF 44% now on Candesartan and Nebivolol. I had a bit of an episode in April and have been told I have:
    ‘episodes of ventricular trigemini and bigeminy. Frequent single ventricular ectopy events with a burden of 8%. Taking into account all ventricular ectopy, the burden was 10%’ –
    Can anybody tells me what this means for me and should I be worried?
    What can I do to improve the situation. I’ve looked at the causes – I don’t drink, smoke, drink coffee or take drugs (other than those above) – but I do enjoy a cup of tea (will now be switching to decaf completely) and I have been under considerable stress caring for a husband with dementia.

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